Research Backs More Strategies for Children with Autism

02/03/2014

The National Professional Development Center (NPDC) on Autism Spectrum Disorders has released its much-anticipated update on evidence-based practices for children and youth with autism.

Scientists at UNC's Frank Porter Graham (FPG) Child Development Institute spearheaded the project, screening 29,000 articles about autism spectrum disorders (ASD) to locate the soundest research on interventions for children from birth to age 22. "More children than ever are being diagnosed with autism," said FPG director Samuel L. Odom, who co-headed the new review. "We're catching them earlier, with better tools, and these children need the right services."

ASD incurs an average lifetime cost of $3.2 million per person, but early diagnosis and effective interventions can reduce that cost by two-thirds.

"Some interventions may seem cutting-edge, but we don't yet know if they have any drawbacks or trade-offs," said FPG investigator Connie Wong, who co-headed the new review of research. "Our report only includes what's tried and true."

"These evidence-based practices are extremely valuable," said Charlotte Crane, an autism consulting teacher and board certified behavior analyst for Loudoun County Public Schools in Leesburg, Virginia. "This report gives us all a way to speak the same language and provide consistent research-based interventions."

Kristine Ganley and Karen Berlin, training and technical assistance providers at George Mason University, heavily rely on the NPDC's reports on evidence-based practices to help people seeking professional development. "We don't provide training on practices not included on it," said Berlin.

According to Ganley and Berlin, before the NPDC published its comprehensive reviews of research, interventions for children with autism were much more controversial. "Internet searches returned as many different approaches as authors behind them, and mastery of any practice was rare," said Ganley. "If there were no reliable report on evidence-based practices, intervention would be based upon myths," added Berlin.

Applying more stringent criteria, the NPDC's new report drops one evidence-based practice from the 24 identified in its 2008 review. After considering more studies this time, scientists also renamed and broadened one category, "technology-aided instruction," and added 5 more, including "exercise" and "structured play groups.""Expanding the list offers more tools to educators and service providers," said Ganley. "This improves outcomes for children with ASD."

Not only does the NPDC's report provide guidance for professionals, it also is an essential tool for families. "Parents often pay for interventions that have no evidence behind them, but this report will allow them to make the best choices," said Odom.

For Allison Smith, the Pawtucket, R.I., mother of identical twin 4-year-old boys with autism, the NPDC reports have helped her to advocate for her sons' services. "Knowledge is power," Smith said. "Knowing what works has given us the upper hand in acquiring appropriate therapy and tools." According to Smith, video modeling, a longtime evidence-based practice from the NPDC's list, helped her boys learn how to blow a feather. Development of this key motor skill is often associated with the ability to speak.

"They couldn't learn how to blow a feather until they watched their older brother doing it on video," she said, even though therapists had been working face-to-face with the boys on the task for months. "But it only took a few viewings of the short clip before both boys got it."

"Being able to research the practices and then try them took a lot of guess work out of the process," said Smith. "If there was no review of evidence-based practices, a lot of children would be without the interventions and services that are most appropriate for them."